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VOLUME 52 | NUMBER 3 | JUNE 2017


Creating Unidimensional Global Measures of Physician Practice Quality Based on Health Insurance Claims Data

Data Sources: Health insurance claims data (October 2007–May 2010) from 134 physician practices in Seattle, WA.

Study Design: We use confirmatory and exploratory factor analysis to develop theory- and empirically driven internally valid composite measures based on 19 quality indicators.

Data Collection Methods: Health insurance claims data from nine insurance companies and self-funded employers were collected and aggregated by third-party organization.

Principal Findings: Our results did not support a single global measure using the entire set of quality indicators. We did identify an acceptable multidimensional model (RMSEA = 0.059; CFI = 0.934; TLI = 0.910). The four dimensions in our data were diabetes, depression, preventive care, and generic drug prescribing.

Conclusions: Our study demonstrates that commonly used process indicators can be used to create a small set of useful composite measures. However, the lack of an internally valid single unidimensional global measure has important implications for policy approaches meant to improve quality by rewarding “high-quality physicians.”

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